African-Americans report less trust in health care providers than whites

A national survey suggests that African-Americans may have lower levels of trust in physicians, nurses and other health care providers than whites, especially if they regularly receive care in a facility other than a physician's office, according to an article in the April 24 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Physicians and researchers are increasingly recognizing the importance of trust in medical care, according to background information in the article. "Trust has been described as an expectation that medical care providers (physicians, nurses and others) will act in ways that demonstrate the patient's interests are a priority," the authors write. Many factors contribute to a patient's trust level, including perceptions of the provider's medical and interpersonal skills. Patients with low trust in their providers may be less likely to comply with treatment, receive recommended screening exams or develop long-term, quality relationships with their physicians.

Chanita Hughes Halbert, Ph.D., Abramson Cancer Center and University of Pennsylvania, Philadelphia, and colleagues evaluated responses from a national survey of 954 adults, including 432 African-Americans and 522 whites. Researchers conducted telephone interviews between July 7 and Sept. 19, 1999. Participants responded to 46 items that assessed their sociodemographic characteristics, prior health care experiences, where they usually receive care and whether their provider's racial background matched their own. Trust in health care providers was rated on a scale of one to four, with one indicating that the participant could trust providers to do what is best for patients almost all of the time and four almost none of the time. Low trust was defined as a rating of three or four.

Low levels of trust were reported by 44.7 percent of African-Americans and 33.5 percent of whites. Although fewer quality interactions with providers predicted low

Contact: Olivia Fermano
JAMA and Archives Journals

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